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대한신경중재치료의학회

Newsletter No.02 / 2018 AUGUST

학술대회 참관기

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KSIN Summer Intensive Course and EACoN 2018 참석후기

최인섭
Neurovascular Center, Mediplex Sejong Hospital, Incheon

지난 주일의 summer meeting 참석후 나의 소감과 후기을 써 달라는 부탁을 받았습니다. 죄송한 말이지만, 내가 한국에 돌아온지 얼마돼지가 않아서 아직 한글typing이 익숙치가 않고 단어가 잘 생각나지 않을때가 많아서, 영어로 쓰는것을 편집부에서 허락해 주셨읍니다. 양해주십시요.

It was delightful 2 days of KSIN and EACon 2018. I was happy to see old friends, most are now retiring or ready to retire from faculty positions, and listen and mingle with younger generation of Neurointervention in Korea as well as in Eastern Asia. It was my third attendance of KSIN meeting, but, it is the first one as a member of the society, not as an invited speaker. I remember it was August, 2009 in Jeju island when I came first time to speak at the summer intensive course and EACoN(?). Most of the presenters were fellows or junior staff members(?) then. Listening to them, I was able to glimpse their intense efforts and courage to show their successes and failures. By showing unexpected or unexplainable events, they were eager to learn from their mistakes. Those who presented cases in 2009 are now experienced and established practitioners and have become teachers of the newer generation. Some have contributed as leaders of the society.

As we experienced in the last 10 years or so, technology in treating cerebrovascular diseases has rapidly improved. For intracranial aneurysms, many complex shaped coils have been introduced and stents to protect parent artery are widely utilized in practice. Flow diverters are another momentous addition for better management of difficult aneurysms. For occlusive diseases, the approach in treating acute stroke patients has been completely transformed, since the results of MR CLEAN trial from Holland published in early 2015. It is the result of many years of efforts to improve tools for endovascular approaches and endless research to understand mechanism and progression of acute stroke. The leaders of the society have timely selected “acute stroke management” as the main theme of this meeting. In the 1st session on acute stroke, the topics were balanced and well presented. Dr. Lee’s presentation was nicely organized and easy to follow. I have learned a lot how to select patients for thrombectomy on basis of imaging modalities. Several presenters showed how to recognize and manage large vessel occlusions associated with underlying arteriosclerotic stenosis. I have again ratified the fact that intracranial stenosis is a lot more common in Asia than in U.S. I have listened indications of intervention for acute stroke patients over 6 hours, DAWN trial for the 3rd time. It is an important trial, but it needs further clarification for appropriate indications in order to apply in day to day practice in my opinion. For cases of summer, I witnessed each one’s struggle to get out of problems and/or achieve proper results. Compared to 2 previous meeting I attended, more tools have been introduced in Korea, thus, problems are different. I witnessed that each one’s skill to utilize those devices are quite good, bases on presented cases. It is the reflection of their good training. One comment I like to make is whether knowledge and interpretation of vascular anatomy and diseases has improved as much as devices and skills to use them have advanced. We all know that our job becomes easier as new or improved devices are introduced. Along with widened indications to treat, practice of neurointervention become busier and more specialists are trained. Subsequently, we may have not been concentrating in learning and teaching fundamentals. I noticed in a few occasions, senior members of our society have not stressed enough the importance of building strong bases to provide better care of patients. To educate younger practitioners better, I encourage the leadership of KSIN to modify the format of the summer meeting to include didactic lectures on basics, so trainees as well as specialists, young and old, can build stronger foundation.

I was delighted to hear a few excellent presentations during EACoN. The materials are a lot more sophisticated and some showed coordinated multi-center data. I believe quality of research has improved tremendously. Certainly, attitude of presenters and the way delivered are maturing.

I enjoyed very much Professor Dong-Ik Kim’s commemorative presentation. He was the first specialist of Interventional Neuroradiology in Korea. I remember he came to NYU first time in 1987 and spent 7(6?) months with us learning what is INR. He later returned and spent a whole year in 1990. He was living in Tenafly in New Jersey. I picked him up every morning on the way to NYU from my house in Closter, N.J. It was a timely opportunity for him, for me as well to introduce Interventional Neuroradiology in Korea. Many enthusiastic colleagues from Korea followed to visit me and work together. Those are the senior group who worked hard to build the services of interventional neuroradiology and endovascular neurosurgery in Korea. I am proud to see the advanced level of endovascular management in Korea and I finally become actually a member of KSIN. I will try to contribute in teaching younger generation of Neurointerventionalist until I completely retire. As a part of my effort, I have organized a teaching course of neurovascular anatomy. I will present embryonic anatomy of each region, followed by Prof. Philippe Mercier’s 3D microscopic surgical anatomy. It will be a unique opportunity to see correlative presentations.

Thanks for reading my comments,

Insup Choi, MD, FACR
Mediplex Sejong Hospital, Incheon

  • 이진수 2018-08-31 19:26:29 KSIN의 실질적 멘토이신 최인섭선생님께서 빠른 시일 내에 장문의 글을 보내주셔서 간행이사로서 진심으로 감사드립니다.

    중간에 DAWN study 등에 대해 실제적인 indication을 잡기 위한 further clarification이 필요하다는 점에 대해 동의합니다.

    감사합니다.

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